Aggression and its association with suicidality in migraine patients: a case-control study

BACKGROUND: To identify aggression and its association with suicidality in migraine patients. METHODS: We enrolled 144 migraine patients who made their first visit to our headache clinic. We collected data regarding their clinical characteristics and the patients completes the Aggression Questionnaire (AQ) and other questionnaires. We also interviewed patients with the Mini International Neuropsychiatric Interview—Plus Version 5.0.0 (MINI) to identify their suicidality. The degree of aggression in migraine patients was compared to the degree of aggression in healthy controls. Major determinants for aggression and its association with suicidality were also examined. RESULTS: The overall AQ score and anger and hostility subscale scores were higher in migraine patients than controls. For migraine chronicity, patients with chronic migraine (CM) had a higher overall AQ score and physical aggression, anger, and hostility subscale scores than controls. On the other hand, all AQ scores in patients with episodic migraine were not different from the scores of the controls. Although several factors were associated with the overall AQ score, major determinants were anxiety (ß = 0.395, p < 0.001), headache intensity (ß = 0.180, p = 0.016), and CM (ß = − 0.165, p = 0.037). Patients who had suicidality based on the MINI showed a higher overall AQ score than patients without suicidality (p < 0.001). CONCLUSIONS: Aggression is likely to be a common feature in CM. Comorbid aggression may help to identify suicidality in migraine patients.